Deborah Davys

Futures planning, parental expectations and sibling concern for people who have a learning disability

A questionnaire was e-mailed to 200 siblings on the Sibs database to explore future plans, parental expectations and sibling concerns regarding people who have a learning disability; 21 questionnaires were returned. A full discussion regarding sibling support was reported by 12 (57%) of respondents; 7 (33%) stated this discussion had not taken place, and 2 (9%) were unsure. Twelve (57%) of participants reported no clear future plan; where a plan did exist, seven (33%) of respondents claimed it was fully agreeable to both them and their parents. Eleven (52%) of respondents reported no difference between their wishes regarding their future role and parental wishes. Key themes generated were: satisfaction with services, parental influence, sibling concern about the future, futures planning, the impact of the disabled person upon sibling lives, and siblings needs. Further qualitative exploration into issues for siblings of adults who have a learning disability is required.

Adult sibling experience, roles, relationships and future concerns – a review of the literature in learning disabilities

AIM This paper provides a review of the literature related to adult siblings of learning-disabled people. BACKGROUND Siblings of learning-disabled people are often looked upon as next of kin when older parents die; however, there is little research regarding sibling views and wishes. DESIGN A literature review of published peer-reviewed empirical research was undertaken. METHOD Electronic databases and citation tracking were used to collate data using key terms such as adult siblings and learning disability. Relevant articles were analysed, compared and contrasted. RESULTS Six key themes emerged suggesting a varied impact of learning disability upon sibling lives in areas that include life choices, relationships, identity and future plans. Some siblings report a positive impact upon life, others state their lives are comparable with other adults who do not have a learning-disabled sibling and others still report a negative impact. Sibling roles and relationships are varied. Evidence suggests that sibling roles, relationships and experience are affected by life stage. Parents often have a primary care role for the disabled person, whilst siblings perform a more distant role; however, sibling involvement often rises when parents are no longer able to provide previous levels of support. CONCLUSION Many factors appear to affect the sibling experience and uptake of roles including gender, life stage and circumstances, level of disability, health status and relationships between family members. Siblings are concerned about the future, particularly when parents are no longer able to provide support, and many appear to have expectations of future responsibilities regarding their disabled sibling. RELEVANCE TO PRACTICE As siblings of people who have a learning disability are often expected by society to provide support, it is important that health and social care practitioners are aware of issues that may impact on this relationship.

Is Clinical Updating a Valuable Mechanism for Enhancing the Student Experience

This opinion piece aims to clarify the concepts of the theory-practice and practice-theory gaps, and to begin to explore the impact of these gaps on efficacious occupational therapy practice. Any perceived gaps between theoretical knowledge and practice skills may have a detrimental effect on the student experience and, ultimately, upon the production of graduates who are fit for practice and purpose. A number of issues are raised. One significant issue is the value of clinical updating for academic staff and its impact upon the student experience. Another issue is the need for further clarification of the definitions of theory-practice/practice-theory gaps and consideration of the impact of these perceived gaps. A need for further research is identified to explore staff perceptions of these issues.

Fathers of people with intellectual disability: A review of the literature:

The aim of this article is to review the literature related to fathers of people who have an intellectual disability (ID). Electronic databases and citation tracking were used to collate data using key terms such as fathers, adults with an ID, learning disability, mental handicap and developmental disability. Relevant articles were analysed and compared for commonality and difference. Eight themes emerged from the literature: response to diagnosis, varied response to ID, concern for the future, work, roles and relationships, impact of fathers upon child development, fathers and service providers, fathers’ needs and coping strategies. This review of the literature presents areas of similarity and divergence and highlights the lack of information that relates specifically to fathers of adults. There are clear messages to service providers to support the inclusion of fathers and the need for further research in this area is indicated.

Professionalism, prejudice and personal taste: does it matter what we wear?

Personal presentation is a way of expressing ones identity. The appearance of the student or the occupational therapist in the workplace is part of his or her professional persona. Discomfort and debate can occur when an individuals appearance conflicts with role expectations. It is part of the occupational therapy educators task to teach students the principles of professional behaviour and presentation. Based on a lunchtime discussion between three occupational therapy lecturers and underpinned by theory, this opinion piece presents some of the arguments surrounding the presentation of the self and what is required in order to work most effectively alongside the service user.

Ageism within occupational therapy

Despite the arrival of the National Service Framework for Older People in 2001, age discrimination continues to exist both in popular society and in health and social care settings. Within this context, the number of older people that are likely to come into contact with occupational therapy services is set to rise because of an increase in the population of older people. This opinion piece provides an overview of ageism towards older people in relation to occupational therapy and suggests basic steps that can be taken by the profession to guard against ageist practice.

Professionalism, Personal Taste and Social Inclusion: Does It Matter What Clients Wear?

An earlier opinion piece considered the professional issues surrounding the occupational therapists dress code within the workplace (Davys et al 2006). This second paper considers the role of the occupational therapist when a clients choice of clothing may conflict with social expectations and have a negative impact upon social inclusion. Three hypothetical cases that reflect clinical realities are presented, which serve as prompts for reflection upon informed choice, professional responsibilities and the therapeutic relationship. It is concluded that there needs to be debate about the conflict between each of these areas and the concept of social inclusion.

Fathers of adults who have a learning disability : roles, needs and concerns

Background: There is little research that specifically relates to fathers of adults with a learning disability despite the social expectation that fathers will provide a supportive role over the lifespan. Methods: Semi-structured interviews were carried out with seven fathers of adults with a learning disability to explore their roles, needs and concerns. Data was analysed using a framework associated with Interpretative Phenomenological Analysis (IPA). Results: Themes arising demonstrate that fathers were shocked at the diagnosis of learning disability but usually reported adaptation over time. The impact of learning disability upon men’s lives, their perception of their adult child and the roles they assumed were varied. Fathers valued support from wives and grandparents; having knowledge and interests and work type roles. All fathers were concerned about the future yet comprehensive futures planning was lacking. Some fathers reported difficulties in being emotionally open, and referred to societal stereotypes. Fathers valued positive support from service providers; however this relationship was often in conflict. Conclusion: Although mothers are often the main carers for adults with a learning disability, fathers can make a significant contribution. The findings presented here support the results of previous studies regarding paternal response to learning disability and varied impact upon men’s lives. Identified support strategies include leisure interests, volunteer/ work roles, having information and support from wives and grandparents. Ongoing concerns incorporate the future and ambivalent relationships with service providers, which could have a negative impact upon the individual who has a learning disability.